Presentation

Patient Data

Loading Stack -

0 images remaining

Frontal

Erect and supine abdominal x-rays. A cluster of calcifications is identified just lateral to the left L2 spinous process. The adjacent soft tissue contour has the appearance of a kidney, however is more medially located than would be expected.

A non contrast renal tract CT was performed.

Loading Stack -

0 images remaining

Axial non-contrast

There is continuity of the renal parenchyma across the midline, in keeping with a horseshoe kidney. The cluster of calcifications seen on the x-ray is confirmed to be in the left renal pelvis. The left ureter is dilated, due to an obstructing calculus located just proximal to the vesicoureteric junction.

3 case question available

Q: What are the most common complications of a horseshoe kidney?
show answer

A: Renal tract calculi and infection. There is also increased susceptibility to trauma, and increased risk of urothelial malignancy.

Loading Stack -

0 images remaining

Axial renal excretory phase

Delayed CT IVP images demonstrate the two halves of the horseshoe kidney joined at a parenchymal isthmus. There is sharp delineation between the normally excreting right kidney, and the delayed nephrogram of the obstructed left kidney, with virtually no excretion into the left collecting system.